Nurse practitioners in developing countries: Some ethical considerations

One of the principles of health care ethics is the principle of justice. An important expression of justice is equity. The provision of basic primary health care services to all people is the key to eliminating the gross ineq uities in health status existing in many countries. For many years nurses i n developing countries have 'led the way' in bringing these essential servi ces to poor rural communities, including the diagnosis and treatment of ill nesses, and the prescribing and dispensing of medications. Nurses are the m ost appropriate health workers for this role, but most have not been prepar ed adequately for it. This is unsafe for patients and puts nurses at legal risk. Justice requires that patients should obtain access to safe health ca re and that nurses should receive appropriate education. Nurse practitioner programmes are being established to prepare nurses for this advanced pract ice role, but here again ethical considerations apply, Justice will be serv ed only if nurse practitioner programmes are accessible to the nurses who a re most likely to work in medically underserved communities where the need is greatest.